- When cut off from social interactions, anxiety results when individuals have nothing but technology to fall back on.
- Months of remote screen–learning and enforced social isolation was enough to turn the most outgoing student moody, withdrawn, and reclusive.
- Loneliness, loss, and anxiety inflict a heavy toll on everyone, but especially the young. Thousands lost a parent or grandparent to COVID–19.
- For many teens the pandemic year was marked by an uptick in self–cutting and suicidal gestures.
In my previous post I touched on the terrible loneliness that pandemic lockdowns triggered for many individuals, and which still lingers even as quarantine measures have eased up. Anxiety is another consequence when individuals—suddenly cut off from coworkers, family, friends, and social circles—have nothing but technology to fall back on. Eighteen months of screens as our primary companion and interface with the outside world has taken its toll.
An uptick in self–cutting and suicidal rumination illustrates how young people are naturally anxious and fragile. For many teens the pandemic year was a nerve–wracking tableau of Emergency Room visits—up 31% for ages 12 to 17 compared to pre–pandemic norms. Emergency Rooms in the U.S. are traditionally the first point of contact for adolescents and teens suffering an acute blow to self–esteem and their sense of worth.
But neither ERs nor families were equipped for the surge of young people in crisis. Psychiatric beds were already in short supply, and minors having a meltdown lacked conventional psychiatric diagnoses such as schizophrenia, meaning that insurance was unlikely to pay for hospitalization (eating disorders, also risen markedly, was an exception). Many hospitals, especially ones outside major cities, even lacked a standing pediatric mental health policy. ERs stitched them up and sent them back home without follow–up support.
Months of remote screen–learning and enforced social isolation was enough to turn the most outgoing student moody, withdrawn, and reclusive. One mother of three blames the indefinite disruption of school life and its predictable routines for changing her extroverted 13–year–old “in profound ways I would never have anticipated.” Young brains are still developing vigorously, won’t be fully mature until age 25, and cannot sustain focused attention for the hours that remote learning demands. Extended screen viewing left many students bored, burned out, and falling behind.
The buoyant promises of what digital devices and an Internet connection can accomplish came up short, especially when young people were given free rein to apportion their own technology use. There is only so much a teacher can do to engage their charges via screen sessions, and huge numbers disappeared from school rosters and went truant.
Media reports in 2021 bolstered ones made earlier by the CDC and academics: loneliness, loss, and anxiety inflict a heavy toll on everyone, but especially the young. Students with initiative created study pods with their friends. But bickering ensued. Cliques formed, and the pods fell apart.
The breakdown of daily routine compounded pandemic–related anxiety—loss of friends, loss of school, loss of sports, and prolonged isolation. The pandemic saw rises in parental neglect, substance abuse, mental illness, and divorce. Thousands lost a parent or grandparent to COVID–19 while distressed parents were unavailable and ineffective. No wonder so many became anxious:
According to a different Harvard study still in progress, structure and routine are crucial when times get tough. Students aged 7 to 15 who maintained structured routines exhibited less anxiety and fewer behavioral problems than their more scattered peers. Before the pandemic, 20–30% were anxious; during it, 66% were. These are prime years for the neuroplasticity that shapes developing brains. We know from pediatric PTSD that brain changes induced by stress can lead to later emotional, cognitive, and academic issues that persist into adulthood.
Children with posttraumatic stress have deleterious alterations in the amygdala (which concerns fear and negative emotion), hippocampus (memory), and prefrontal cortex (flexibility and resilience). In the same way that associative learning influenced Pavlov’s dogs, adverse incidents that affect the young such as divorce, parental neglect, drug use, or a death condition them to become overly sensitive to cues such as isolation, separation from friends, or fomo that remind them of the original trauma.
Thanks to child psychiatrist Victor Carrion, director of Early Life Stress Research at Stanford, we know this through brain imaging and the clever use of cortisol—the body’s primary stress hormone—as a cumulative biomarker of stress. Cortisol concentrations in hair samples serve as a time line and chronological record of childhood exposure to distressing experiences. Compared to PTSD from accidents and natural disasters, damage inflicted by the current pandemic may end up being worse because of its long if not indefinite duration.
What will the long–term consequences be? It’s a pertinent question given the elevated level of self–injury, eating disorders, and cratering mental health observed during the pandemic. Spending a year away from the classroom, previously high–performing students saw their grades tank unexpectedly. Teachers and parents, already harried by the demands of remote learning, hadn’t had time to think about the ways young people might cope and build resilience in the face of accumulating challenges.
With hardly any travel or party photos posted to social media during quarantines, did older students still feel they were missing out on fun that peers might be having without them? Studies showed that fomo was simply replaced by judgments about new online activities such as remote concerts, happy hours, and group games. Redirected fomo might plausibly account for loss of focus and flagged productivity. YouTube, videogames, and TikTok were also more compelling than schoolwork, beckoning users to ditch their virtual classrooms.
According to the CDC’s ongoing Household Pulse Survey, adults also endured digital distractions and the consequences of inattention. For example, weekly podcast listening went up 17% compared to pre–covid years, turning podcasts into yet another pandemic distraction and an escape from people in one’s orbit. Time alone may have been welcomed at first, but it unwittingly led to reduced intimacy and further social isolation.
Part III speaks to Reactionary outrage and a mindset of exhausted numbness. Kindly direct questions to Dr. Cytowic via the author portal.
Hill, R.M., et al., Suicide ideation and attempts in a pediatric emergency department before and during COVID-19. Pediatrics, 2021. 147(3)
Carey, B., For Some Teens, It’s Been a Year of Anxiety and Trips to the E.R. New York Times, February 23, 2021 doi: nytimes.com/2021/02/23/health/coronavirus-mental-health-teens.html.
Rosen, M., A. Rodman, and S. Kasparek, Promoting youth mental health during COVID-19: A Longitudinal Study spanning pre- and post-pandemic. PsyArXiv Preprints, March 26, 2021. doi: 10.31234/osf.io/n5h8t.
Lopez, M., et al., The social ecology of childhood and early life adversity. Pediatric Research, January 18, 2021. 89(2): p. 353-367. doi: 10.1038/s41390-020-01264-x.
Weems, C.F., et al., Translating the neuroscience of adverse childhood experiences to inform policy and foster population-level resilience. American Psychologist, March 18, 2021. 76(2): p. 188-202. doi: 10.1037/amp0000780
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Vahratian, A., et al., Symptoms of Anxiety or Depressive Disorder and Use of Mental Health Care Among Adults During the COVID-19 Pandemic — United States, August 2020–February 2021. CDC Morbidity and Mortality Weekly Report, April 2, 2021. 70: p. 490-494. doi: org/10.15585/mmwr.mm7013e2.